| Autor: |
Valk SJ; Jon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden., Caram-Deelder C; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden., Groenwold RHH; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden., Evers D; Department of Haematology, Radboudumc, Nijmegen., De Vooght KMK; Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht., Van de Kerkhof D; Department of Clinical Chemistry and Haematology, Catharina Hospital, Eindhoven., Wondergem MJ; Department of Haematology, Amsterdam UMC, location VUmc, Amsterdam., Péquériaux NCV; Department of Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's Hertogenbosch., Hudig F; LabWest, Haga Teaching Hospital, The Hague., Zwaginga JJ; Jon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands; Department of Haematology, Leiden University Medical Center, Leiden., Middelburg RA; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden., Van der Bom JG; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden. j.g.van_der_bom@lumc.nl. |
| Abstrakt: |
Previous studies found exposure to red blood cell transfusions from female donors who have been pregnant reduces survival in male patients compared to exposure to male donor products, but evidence is not consistent. We postulate the previously observed association is modified by offspring sex, with an expected increased mortality risk for male patients receiving units from female donors with sons. Here, marginal structural models were used to assess the association between exposure to units from ever-pregnant donors, ever-pregnant donors with sons and ever-pregnant donors with daughters, and mortality. Clinical data were collected on first-ever transfusion recipients in the Netherlands and donor data were supplemented with information about offspring sex and date of birth. In this analysis, 56,825 patients were included, of whom 8,288 died during follow-up. Exposure to red blood cell units from ever-pregnant donors with sons was not associated with increased all-cause mortality risk among male transfusion recipients (hazard ratio [HR]=0.91, 95% confidence interval [CI]: 0.83-1.01). Exposure to ever-pregnant donors, irrespective of offspring sex, was associated with mortality in male patients aged between 18 and 50 years (ever-pregnant donors: HR=1.81, 95% CI: 1.31-2.51) compared to male donor units, but was protective in female patients. This study suggests that the observed increased mortality risk for exposure to red blood cell units from parous female donors does not depend on offspring sex. The increased risk of mortality seen in younger adult male patients is consistent with previous observations, but the underlying biological mechanism could not be identified in this study. |
